Individual
CLARISSA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12895 PINE MEADOW CT, SAN DIEGO, CA 92130-2438
(707) 815-0553
Mailing address
12895 PINE MEADOW CT, SAN DIEGO, CA 92130-2438
(707) 815-0553
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
42962
CA
Other
Enumeration date
10/29/2015
Last updated
10/29/2015
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